CPT 92507 is being replaced in 2027: the new speech therapy treatment codes, explained

Starting January 1, 2027, CPT code 92507 is deleted, and individual speech-language treatment moves to 10 new timed codes, 92654 through 92663: a base code for the first 30 minutes and an add-on code for each additional 15 minutes, in five treatment areas (fluency; speech sound production; language; speech sound and language together; and voice, upper airway and resonance). Group treatment stays on 92508, still untimed. Medicare uses the new codes in 2027, while Medicaid programs and private insurers set their own timelines and rules (ASHA (opens in a new tab); CMS final rule (opens in a new tab)).

In short: keep billing 92507 for dates of service through December 31, 2026. From January 1, 2027, choose the code pair for the disorder area you treated, and count units from direct one-on-one treatment minutes. Under the usual CPT midpoint rule, 16 to 37 minutes is the base code alone, 38 to 52 adds one add-on, and each further 15 minutes adds another. Treating speech sound and language in one session uses the combined pair. Start writing minutes per disorder area (and start and stop times, if a payer wants them) into every note now, and ask each payer and your billing vendor when they switch.

Last checked November 7, 2026. This is general information, not coding, billing or legal advice. Rules differ by payer and can change before January. Confirm with each payer, your billing company and ASHA’s coding resources (opens in a new tab) before you bill; ASHA’s reimbursement team takes questions at reimbursement@asha.org.

I’m Ryan, an SLP grad student, and I built SLPcentral, a caseload and notes app (not billing software). Private-practice SLPs I talk to are stressed about this change, so I went to the primary sources: ASHA, CMS and the AMA. Every fact below links to one of them, and the dated list is under Sources at the end.

What’s changing, and when

The AMA’s CPT Editorial Panel approved the change at its September 2025 meeting: new codes for individual speech treatment, a revised 92508, and the deletion of 92507, effective January 2027 (AMA summary of panel actions (opens in a new tab)). The AMA released the full CPT 2027 code set on September 9, 2026, effective January 1 (AMA (opens in a new tab)). ASHA explains why: one broad, untimed code no longer gave the detail current CPT standards expect, and a rise in Medicare billing for 92507 set off a review (ASHA background (opens in a new tab)).

For Medicare, CMS’s final 2027 Physician Fee Schedule rule (put on public display November 4, 2026, and scheduled for the Federal Register on November 9) adopts all 10 codes and the revised 92508 for 2027 (CMS-1848-F (opens in a new tab)).

• Through December 31, 2026: bill 92507 as usual.
• January 1, 2027: 92507 leaves the CPT code set, the new codes start, and Medicare pays them.
• Medicaid and private insurers: on their own schedule. ASHA says they aren’t required to adopt the change or Medicare’s rates, so timelines will vary (ASHA (opens in a new tab)). Its readiness checklist says to make sure your billing software has both 92507 and the new codes (checklist (opens in a new tab)).

Old vs new at a glance

The 10 new codes

All 10 are for direct, one-on-one treatment. An add-on code is never billed alone; it always goes with its own base code (ASHA quick guide (opens in a new tab)).

Auditory processing and cognitive-communication don’t get their own pair. ASHA’s code page says to choose the code that best describes the disorder you treated and your one-on-one time, and to ask its reimbursement team when you’re unsure (ASHA (opens in a new tab)). In the final rule, CMS noted a request for a cognitive-communication code and said it may consider one in future rulemaking (final rule, p. 225 (opens in a new tab)).

How time and units work

Count only direct, one-on-one treatment minutes. Chart review, care-team meetings and other paperwork don’t count, and the appointment length doesn’t set the code: a 45-minute appointment with 40 minutes of treatment is coded on the 40 (ASHA (opens in a new tab)). Under the general CPT midpoint convention (the “51% rule”), ASHA’s quick guide gives this ladder for each code pair (quick guide (opens in a new tab)):

Not every payer uses the midpoint. ASHA’s readiness checklist says Medicare follows the 51% rule, and tells you to ask each Medicaid program and private insurer whether they require 51% or 100% of the time (checklist (opens in a new tab)). Under a 100% rule, a 24-minute session may not meet a 30-minute base code at all.

The same minutes count once. ASHA’s example: in a 60-minute session with 20 minutes of voice work and 40 of speech sound work, you count 20 and 40, which add up to 60, never more (ASHA (opens in a new tab)). When you treat two areas, you may report more than one base code if each is a separate, medically necessary service that meets its own time, is documented separately, and the payer allows it. The exception is speech sound plus language: that combination uses the combined pair, 92660 and 92661 (quick guide (opens in a new tab)).

Medicare’s extra rules

• Always therapy. CMS made all 10 codes and 92508 “always therapy” services: they need a therapy plan of care and a therapy modifier on the claim, whoever provides them (final rule, pp. 225–226 (opens in a new tab)). ASHA names GN, the speech-language pathology modifier, as the example (ASHA (opens in a new tab)).
• Payment reduction. The five base codes fall under Medicare’s multiple procedure payment reduction for therapy; the add-on codes don’t (final rule, p. 226 (opens in a new tab)).
• Telehealth. The 10 codes replace 92507 on Medicare’s telehealth list for 2027 (final rule, p. 91 (opens in a new tab)). ASHA notes that Congress has authorized SLP telehealth under Medicare only through December 31, 2027, unless it acts again (ASHA (opens in a new tab)).
• A pediatric option, G0903. The final rule creates a Medicare code for individual pediatric speech treatment, valued like 92507, untimed, and billed once a day. For a patient through age 21 (until the 22nd birthday) you may use it or the 10 new codes, but not both for the same service. Summaries of the proposal described a 60-minute requirement; the final rule says the 60 minutes is only for valuing the code, not a minimum session length. The rule words the age limit two ways (“age 21 and under”, “up to age 21”) and clarifies it means through 21 years and 364 days (final rule, pp. 226–234 (opens in a new tab)). G0903 is Medicare’s code, not a CPT code, so ask any other payer before you use it.

Four made-up sessions, worked through

• Maya, /s/ blends only. A 45-minute appointment with 40 minutes of direct treatment, all speech sound. 38–52 minutes: 92656 plus one 92657.
• Jonah, /r/ and following directions. 45 minutes of direct treatment, moving between a speech sound goal and a language goal. Both areas: the combined pair, 92660 plus one 92661, not 92656 and 92658 together.
• Ella, fluency. A 30-minute appointment: 24 minutes of direct treatment, the rest setup and her note. 16–37 minutes: one 92654. A payer with a 100% rule might not accept it.
• Leo, language. 14 minutes of treatment before he had to leave early. Under 16 minutes, it isn’t reported separately under the midpoint convention.

These follow ASHA’s ladder under the midpoint convention. Your payer’s rules decide the real claim.

What to change in your documentation now

You don’t have to wait for January. These habits line up with the documentation checkpoint in ASHA’s quick guide (opens in a new tab) and its practice page (opens in a new tab):

1. Minutes per disorder area. Write the direct one-on-one minutes for each area you treated, not only the appointment length: “speech sound 20 min, language 20 min.”
2. Start and stop times, if any payer you bill asks for them. ASHA lists them as payer-dependent, so check.
3. Which area each activity targeted. Tie each activity and its data to a goal, and each goal to its area (fluency, speech sound, language, voice). That shows which code pair the minutes belong to.
4. The skilled part. What you did that needed an SLP, the client’s response, and progress toward the functional goal.
5. Time that doesn’t count, left out. Setup, charting and team meetings aren’t treatment minutes.
6. The link to the plan of care. How each service connects to it; for Medicare, the plan of care is required.

For what the rest of a session note should hold, see SLP SOAP note examples.

Where SLPcentral fits (full disclosure: I built it). The new codes depend on accurate minutes and data for each goal area. In SLPcentral you tap each trial for each goal during the session, and Ollie, the app’s AI assistant, drafts the note from that data, goal by goal, so each goal’s numbers are already in the draft when you review it. You add the treatment minutes per area (and start and stop times, if a payer wants them), edit, and save; the draft doesn’t fill in minutes for you today. SLPcentral isn’t billing software: it doesn’t pick, suggest or submit codes, and it can’t promise a claim gets paid. Licensed SLPs start with a 14-day free trial on yearly, 7-day on monthly. Start your free trial

Group sessions

92508 stays the code for group treatment of two or more people. It’s untimed with no minimum time, and it’s now a stand-alone code rather than a companion to 92507 (ASHA quick guide (opens in a new tab)). ASHA’s code page adds that it isn’t reported together with the group adaptive-behavior codes 97154 or 97158 (ASHA (opens in a new tab)). For Medicare, it stays an always-therapy service (final rule, p. 226 (opens in a new tab)). Score each student’s data against their own goal, as before.

What to ask your EHR or billing vendor

• Are 92654–92663 and the revised 92508 loaded, and will 92507 stay available for 2026 dates of service and any payer still using it?
• Can a note record treatment minutes per disorder area, and start and stop times?
• Does it calculate units payer by payer, with a 51% or a 100% rule?
• Does it keep each add-on with its own base code, and flag speech sound and language billed as two separate pairs?
• Will superbills, good faith estimate templates and note templates be updated before January 1?
• How will it handle claim edits (NCCI) and medically unlikely edits (MUEs)? ASHA expects the MUEs to be announced in the last quarter of 2026.

And ask each payer

• Do you accept the new codes for 2027 dates of service, or is there a transition period?
• Do you need 51% or 100% of the time for a unit?
• Do existing prior authorizations need to be updated to the new codes?
• How do base and add-on codes count toward visit or unit limits?
• Are there same-day billing limits?
• If the client has secondary insurance: do both payers use the same code set?

ASHA suggests writing down who you asked, when, and any reference number, and treating anything unanswered as unresolved rather than assumed (ASHA (opens in a new tab)). Its readiness checklist has the full list (checklist (opens in a new tab)).

What this means for school SLPs

If your district bills Medicaid for speech services, whether those claims move to the new codes on January 1, 2027 depends on your state’s Medicaid program. ASHA says Medicaid programs set their own coding and payment policies, and its readiness checklist sends Medicaid questions to the state program, through the state education or health department (ASHA news (opens in a new tab); checklist (opens in a new tab)). As of November 7, 2026, ASHA’s pages on the new codes give no school-specific rules.

Ask your district’s Medicaid billing coordinator which codes the state wants for 2027 services, whether units follow a 51% or a 100% rule, and whether your session logs need minutes per disorder area. The documentation habits above are worth keeping either way. Medicare’s pediatric code, G0903, is a Medicare rule and doesn’t decide what your state’s Medicaid program does.

What about payment?

CMS’s final rule kept the work values it had proposed for all 10 codes and 92508 (final rule, p. 225 (opens in a new tab)). ASHA’s per-code dollar estimates (updated November 5) were figured with the proposed conversion factor, and CMS’s final rule set a different one for 2027 ($32.63, or $32.95 for qualifying APM participants), so treat those dollar amounts as estimates until final 2027 figures are posted (ASHA (opens in a new tab); CMS fact sheet (opens in a new tab)). Medicaid programs and private insurers set their own rates.

Frequently asked questions

Sources

• AMA: CPT Editorial Panel summary of panel actions, September 2025 (opens in a new tab) (updated October 24, 2025); CPT 2027 code set release (opens in a new tab) (September 9, 2026)
• CMS: CY 2027 Physician Fee Schedule final rule, CMS-1848-F (opens in a new tab) (displayed November 4, 2026; Federal Register publication November 9, 2026); the final rule’s display copy (opens in a new tab) (speech-language pathology codes pp. 219–234, telehealth pp. 91–94); final rule fact sheet (opens in a new tab) (November 4, 2026)
• ASHA: treatment codes replacing 92507 (opens in a new tab) (cites the November 4, 2026 final rule); the new codes (opens in a new tab); putting them into practice (opens in a new tab); background (opens in a new tab); treatment coding quick guide (PDF) (opens in a new tab); readiness checklist (PDF) (opens in a new tab) (these pages show no date)
• ASHA news: CMS proposes Medicare payment for the new codes (opens in a new tab) (updated November 5, 2026); 2027 Medicare Part B rule analysis (opens in a new tab) (updated November 5, 2026; it analyzes the proposed rule, with a final-rule analysis to come)

Last checked November 7, 2026. Where an ASHA page written about the proposed rule differs from CMS’s final rule (G0903’s time requirement, the dollar estimates), this post follows the final rule.

Drafted with AI help from the sources listed, then reviewed and edited by Ryan Lillard. He built SLPcentral, which doesn’t do billing or coding. Students in examples are fictional. This article is general information, not coding, billing or legal advice; confirm with your payers, your billing company and ASHA’s resources.